Provider Demographics
NPI:1922172246
Name:JAVAHIRYAN, HAGOP
Entity Type:Individual
Prefix:
First Name:HAGOP
Middle Name:
Last Name:JAVAHIRYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 S GLENDALE AVE
Mailing Address - Street 2:UNIT A3
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2803
Mailing Address - Country:US
Mailing Address - Phone:818-409-8910
Mailing Address - Fax:818-409-8930
Practice Address - Street 1:919 S GLENDALE AVE
Practice Address - Street 2:UNIT A3
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2803
Practice Address - Country:US
Practice Address - Phone:818-409-8910
Practice Address - Fax:818-409-8930
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies